22 male

Question 1

inflammatory diseases of male reproductive

Answer 1

viral
bacterial

Question 2

viral herpis genitalis
1 or 2
3 Ms of hsv infected cell and known as

Answer 2

Herpes genitalis
HSV-2&raquo_space;> HSV-1
Multiple vesicles and painful ulcer develop 3 to 7 days after infection and heal spontaneously in 1 to 3 weeks.
During the acute infection the virus migrates to the regional lumbosacral nerve ganglia and establishes a latent infection.

margination
molding
multinucealtion

coedry bodies

Question 3

Human papilloma virus (HPV)

Answer 3

Oncogenic virus
Causes condyloma acuminatum, precancerous lesion and cancer

Question 4

HPV cells known as
and why named so

Answer 4

koliocytes

kolio means hollow
cyte cell

hollow cells because cells have perinuclear hollow region

Question 5

Genome of HPV
what makes it oncogenic

Answer 5

E6 inactivate P53 and telomerase expression,
E7 inactivate Rb and
E5 perinuclear vacuole (halo)

Question 6

Pox virus (mulluscum contagiosum virus)

Answer 6

Cause mulluscum contagiosum
Dome-shaped papules with a dimpled center.
mcv2 std

Question 7

Chancroid (Soft Chancre)

Answer 7

Chancroid (Soft Chancre)
Gram-negative bacillus, Haemophilus ducreyi
Cause painful genital ulcer

Question 8

Lymphogranuloma veneurum (LGV):

Answer 8

C. trachomatis (L1, L2 and L3)
Starts as painless papules that develops an ulcer.
After a few days painful regional lymphadenopathy develop (necrotizing granulomatous inflammation of the inguinal lymphatics and lymph nodes)
Rectal stricture may be seen with perianal involvement.

Question 9

grooves sign

Answer 9

enlarged LN splited by pouparts ligament

Question 10

Granuloma inguinale (Donovanosis)

Answer 10

Caused by intracellular gram-negative bacterium Klebsiella granulomatis.
Non suppurative painless genital ulcer and beefy-red appearance

Question 11

donovan bodies

Answer 11

safety pin like bodies inside monocytes

Question 12

Urethritis
define
classification
accompanied by

Answer 12

Urethritis = Inflammation of urethra
Classified as gonococcal and non gonococcal
Present with urethral discharge, and dysuria.
Urethritis is often accompanied by cystitis in women and by prostatitis in men.

Question 13

Example of non infectious urethritis is

Answer 13

reactive arthritis (formerly Reiter syndrome), which is associated with the clinical triad of arthritis, conjunctivitis, and urethritis

Question 14

causes of urethral stricture
inflammatory
traumatic
catheter
post op prostectomy

Answer 14

bulbar

membraneous

all

prostatic

Question 15

Prostatitis
define
types
difference between them

Answer 15

= Inflammation of prostate

Acute bacterial prostatitis
Presents with dysuria, frequency, urgency, low back pain.
Warm, tender, enlarged prostate on digital rectal exam.
Prostatic secretions show WBCs and culture reveals bacteria.
Chronic prostatitis
Presents as dysuria with pelvic or low back pain
Prostatic secretions show WBCs, but cultures are negative.

Question 16

Epididymitis
define
present as
clinical exam for prostitis
in what disease epididymis affcted first

Answer 16

Epididymitis = Inflammation of epididymis

Presents with localized pain and tenderness over posterior testis.
Positive Prehn sign (pain relief with scrotal elevation).
May progress to involve testis.
Tuberculosis - epididymis involved first with caseating granuloma on histology

Question 17

Orchitis
define
presentation
types
what disease is testis involved first

Answer 17

inflammation of testis
Orchitis presents with testicular pain and swelling.

Granulomatous (autoimmune) orchitis-

Mumps orchitis -

Syphilis - testis is involved first with obliterative endarteritis and gumma on histology.

Question 18

granulomatous and mumps orchitis

Answer 18

characterized by granulomas involving the seminiferous tubules. Idiopathic (antisperm antibodies (ASA))

rare in males < 10 years old. Most often seen 1 week after parotid glands enlagment. Infertility risk.

Question 19

balanitis

Answer 19

inflammation of glans penis

Question 20

phimosis
and paraphimosis

Answer 20

inhabilty to retract foreskin

inability to reduce the forskin back to anatomical postion

Question 21

Fournier gangrene

Answer 21

Polymicrobial necrotizing fasciitis involving the genital areas and perineum
Surgical emergency

Question 22

congenital penile abnormality

Answer 22

hypospadias

epispadias

Question 23

hypospadias
cause
where

Answer 23

failure of urethral folds to fuse

opening under

Question 24

epispadias
where
cause
assoc.tion

Answer 24

faulty positioning of genital tubercle

assoc. with extrophy of bladder

Question 25

Invasive Squamous Cell Carcinoma

Answer 25

Most common type of penile cancer.
40 to 70 years of age
< 1% of all cancers of the male
in some parts of Asia, Africa, and South America, penile cancer accounts for 10% to 20% of male malignancies

Question 26

scrotal carcinoma

Answer 26

Scrotal carcinoma, also known as squamous cell carcinoma of the scrotum, is a rare form of cancer that affects the skin of the scrotum. It is primarily associated with occupational exposure to certain substances, particularly in chimney sweepers during the industrial revolution.

Question 27

Cryptorchidism

Answer 27

Cryptorchidism
(Gr: kryptos = hidden and orchis = testicle)
Descent failure of one or both testes
80% are unilateral and 20% are bilateral
Most common congenital male reproductive abnormality
Most cases are clinically asymptomatic and discovered only on physical examination.

Question 28

An undescended testis is called …………. when it can be manipulated into scrotum where it remains without tension. On the other hand, when it can be manipulated into upper scrotum but retracts when released, it is called ……………

Answer 28

retractile

gliding

Question 29

On gross examination, the cryptorchid testis is small and fibrotic. Histologically, there is marked reduction in the number of germ cells.
why?

Answer 29

Impaired spermatogenesis (since sperm develop best at temperatures < 37°C)

Question 30

~ 80% descend by the first year of life making the actual incidence about ~1%
Otherwise, orchiopexy performed before 2 years of age.

Question 31

Benign intrascrotal lesions

Answer 31

hydrocele
spermatocele
varicocele

Question 32

Varicocele
define
where
epidemology
causes
looks like what on

Answer 32

Dilated spermatic vein in pampiniform plexus due to impaired drainage
Most common cause of intrascrotal enlargement in adult males
Most often on left side
Can cause infertility because of temperature
Diagnosed by standing clinical exam/Valsalva maneuver (distension on inspection and “bag of worms” on palpation) or ultrasound

Question 33

Hydrocele
DEFINE
types

Answer 33

Serous fluid collection within the tunica vaginalis
Congenital hydrocele: Common cause of scrotal swelling in infants, due to incomplete obliteration of processus vaginalis. Most spontaneously resolve within 1 year.
Acquired hydrocele: Scrotal fluid collection usually 2° to infection, trauma, tumor, due to blockage of lymphatic drainage
Hematocele when the fluid is blood.

Question 34

Spermatocele

Answer 34

Spermatocele = Cyst due to dilated epididymal duct or rete testis. Filled with spermatozoa

Question 35

Testicular torsion
due to
looks like

Answer 35

Rotation of testicle around spermatic cord and vascular pedicle.
Commonly presents 12–18 years old.
May occur after an inciting event (eg, trauma) or spontaneously.
Usually due to congenital failure of testes to attach to the inner lining of the scrotum (via the processus vaginalis)
Characterized by acute (sudden), severe pain, high-riding testis, and absent cremasteric reflex.

bell capper

Question 36

types of testicular tumorr

Answer 36

germ cell tumor
sex cord tumor

Question 37

germ cell tumors type

Answer 37

seminomal and non seminomal

Question 38

Seminoma
define
pain?
analogue
occurance
produce what
prognosis

Answer 38

Malignant and painless tumor
Most common testicular tumor
Analogous to ovarian dysgerminoma and extragenital germinoma.
Does not occur in infancy
Placental alkaline phosphatase (PLAP) and 15% HCG
Excellent prognosis - Highly radiosensitive with late metastasis.

Question 39

Embryonal carcinoma
define
pain
produces
prognosis
differnece from seminoma

Answer 39

Comprised of immature primitive cells that may produce glands

Malignant and Painful tumor
Pure embryonal carcinoma is rare
May be associated with increased hCG and normal AFP levels when pure (increased AFP when mixed).
Aggressive with early hematogenous spread.
Chemotherapy may result in differentiation into another type of germ cell tumor (e.g., teratoma).

there is necrosis with hemorhage

Question 40

Teratoma
define
when malignat and when benign

Answer 40

Composed of mature fetal tissue derived from two or three embryonic layers.
Mature teratoma may be malignant in adult males.
Benign in children and females.

Question 41

Yolk sac (endodermal sinus) tumor
define
epidemology
bodies seen
what is elevated

Answer 41

Most common testicular tumor in children < 3 years old
Schiller-Duval bodies resemble primitive glomeruli are seen on histology
AFP is characteristically elevated
Aggressive tumor
In adults is mixed with embryonal carcinoma

Question 42

Choriocarcinoma
define
metastasize ?
tumor marker
may cause

Answer 42

Malignant tumor of syncytiotrophoblasts and cytotrophoblasts (placenta-like tissue, but no villi).
Early hematogenous metastasis
Tumor marker HCG
May produce gynecomastia and hyperthyroidism

Question 43

Sex cord stromal tumor
epidemology ben or mal?
types

Answer 43

5% of all testicular tumors
Mostly benign
Leydig cell tumor
Sertoli cell tumor (androblastoma) is comprised of tubules and is usually clinically silent.

Question 44

leydig cell tumor
produce?
causes?
histologically what cells seen

Answer 44

usually produces androgen or estrogens , causing precocious puberty in children or gynecomastia in adults.

Question 45

Primary testicular lymphoma (PTL)
epidemology
type
laterality

Answer 45

Most common testicular tumor in males > 60 years old.
Typically diffuse large B-cell lymphoma (DLBCL).
Usually bilateral, and most have disseminated at the time of diagnosis.

Question 46

The most common benign paratesticular tumor is

Answer 46

adenomatoid tumor.

Question 47

The most common malignant paratesticular tumors are ………………….in children and ………………. in adults.

Answer 47

rhabdomyosarcomas

liposarcomas